When performing a draw on a diabetic patient with small, fragile veins, and the phlebotomist misses the patient's vein twice, what should the phlebotomist do next?
Ask another phlebotomist to obtain the specimen.
Perform the draw on a foot.
Repeat the draws until the phlebotomist is successful.
Perform the draw on a leg.
The Correct Answer is A
Choice A reason:
Asking another phlebotomist to obtain the specimen is a prudent step after multiple unsuccessful attempts. It can reduce the patient's discomfort and anxiety. A fresh perspective from another professional might increase the chances of a successful draw, especially in challenging situations like small, fragile veins often found in diabetic patients.
Choice B reason:
Performing the draw on a foot is not typically recommended due to the increased risk of infection and complications, especially in diabetic patients who may have reduced sensation and slower healing in their extremities. This option should only be considered when other more proximal sites have been deemed unsuitable.
Choice C reason:
Repeating the draws until successful is not advisable as it can cause undue stress to the patient and increase the risk of hematoma or vein damage. It is essential to minimize the number of attempts to prevent patient discomfort and potential complications.
Choice D reason:
Performing the draw on a leg is another option that is generally avoided unless absolutely necessary, due to similar reasons as drawing from a foot—risk of infection and complications. Additionally, it can be an uncomfortable position for the patient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
The red top tube is typically used for serum determinations in chemistry, serology, and blood bank. It contains no additive or may contain a clot activator. The red top tube is not the first choice for capillary puncture order of draw because it is designed for tests that require serum and not whole blood.
Choice B Reason:
The lavender top tube is used for whole blood hematology determinations, as it contains EDTA as an anticoagulant. According to the order of draw for capillary punctures, the EDTA tube should be collected first to ensure adequate volume and accurate hematology test results. This makes the lavender top tube the correct choice for the first collection in this scenario.
Choice C Reason:
The light blue top tube contains sodium citrate and is used for coagulation tests. In venipuncture, it is drawn after the blood culture bottle and before other tubes to prevent contamination with additives from other tubes. However, for capillary punctures, it is not the first choice as hematology tests take precedence.
Choice D Reason:
The royal blue top tube is used for trace element, toxicology, and nutrient determinations². While it may be used for lead and toxicology screens mentioned in the question, it is not the first tube to be drawn in a capillary puncture sequence. The EDTA tube (lavender top) is drawn first to prevent clotting and ensure accurate CBC results.
Correct Answer is A
Explanation
Choice A Reason:
The supine position, where the patient lies flat on their back with the face upward, is the correct position for initiating CPR. This position allows for proper chest compressions and airway management, which are critical components of CPR.
Choice B Reason:
The Semi-Fowler's position, where the patient is partially sitting up with the head of the bed raised to 30-45 degrees, is not suitable for CPR. This position would make it difficult to perform effective chest compressions.
Choice C Reason:
The prone position, where the patient lies flat on their stomach, is not appropriate for CPR. Chest compressions cannot be effectively delivered in this position, and it would also complicate airway management.
Choice D Reason:
The side-lying position is not appropriate for CPR. While this position can be used for an unconscious patient who is breathing normally to maintain an open airway and prevent aspiration, it is not suitable for CPR, which requires the patient to be on their back.
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